Revised 3/2018 
 
 
DEPARTMENT OF PLANNING AND NATURAL RESOURCES 
Division of Comprehensive and Coastal Zone Planning 
 
REQUEST FOR ZONING CERTIFICATION 
 
 
NAME: ________________________________________________________  
 
TEL: ________________ EMAIL: _____________________________________ 
 
MAILING ADDRESS: ______________________________________________  
 
CITY:_______________ STATE: _______________ 
ZIP: ____________  
 
ZONING CERTIFICATION REQUEST IS FOR: 
 
PLOT NO(S) AND ACREAGE: _______________________________________  
________________________________________________________________ 
________________________________________________________________ 
 
PARCEL ID NUMBER: _____________________________________________ 
 
CURRENT USE OF PROPERTY: _____________________________________ 
________________________________________________________________ 
________________________________________________________________ 
 
TOTAL NUMBER OF RESIDENTIAL UNITS ON PROPERTY:  _____________ 
 
PROPOSED USE OF PROPERTY: ___________________________________ 
________________________________________________________________ 
 
 
REASON FOR REQUEST: __________________________________________  
 
 
 
PLEASE NOTE: A SURVEY OR OTHER DOCUMENTATION MAY BE 
REQUESTED TO COMPLETE THE ZONING CERTIFICATION.